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General NPI Number Information
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NPI Number | 1649086190
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Entity Type | Organization
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Legal Business Name | GOOD SEEDS NUTRITION LLC
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Dates
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Enumeration Date | 12/09/2024
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Last Update Date | 12/09/2024
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Provider Practice Location Address
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Address Line | 8925 LANTANA MEADOW DR
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City | FORT WORTH
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State | TX
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Zip | 76131-1933
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Country | US
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Telephone | 908-674-3042
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Fax |
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Provider Business Mailing Address
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Address Line | 8925 LANTANA MEADOW DR
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City | FORT WORTH
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State | TX
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Zip | 76131-1933
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Country | US
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Telephone | 908-674-3042
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN, FOUNDER
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Name | MARY KOBRAN
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Credential | RDN
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Telephone | 908-674-3042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 136A00000X
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Taxonomy Name | Registered Dietetic Technician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 174N00000X
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Taxonomy Name | Lactation Consultant (Non-RN)
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225XF0002X
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Taxonomy Name | Feeding, Eating & Swallowing Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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